WordNet

secure with a cramp; "cramp the wood"
affect with or as if with a cramp
suffer from sudden painful contraction of a muscle
a strip of metal with ends bent at right angles; used to hold masonry together (同)cramp iron
a clamp for holding pieces of wood together while they are glued
cause emotional anguish or make miserable; "It pains me to see my children not being taught well in school" (同)anguish, hurt
a symptom of some physical hurt or disorder; "the patient developed severe pain and distension" (同)hurting
a bothersome annoying person; "that kid is a terrible pain" (同)pain in the neck, nuisance
a somatic sensation of acute discomfort; "as the intensity increased the sensation changed from tickle to pain" (同)pain_sensation, painful sensation
emotional distress; a fundamental feeling that people try to avoid; "the pain of loneliness" (同)painfulness
the muscles of the abdomen (同)abdominal_muscle, ab
of or relating to or near the abdomen; "abdominal muscles"

PrepTutorEJDIC

〈U〉〈C〉(筋肉の)けいれん,こむらがえり / 《複数形で》急激な腹痛 / …‘に'けいれんを起こさせる
(また『cramp iron』)かすがい / 締め具,締め金 / …'を'かすがい(締め具)で締めつける / …'を'拘束する
〈C〉〈U〉(肉体のある部分の)『苦痛』,『痛み』 / 〈U〉(精神的な)『苦痛』,心痛 / 《複数形で》骨折り,苦労,努力 / 〈C〉不快感,いやな感じ;うんざりさせるもの,やっかい者 / (肉体的・精神的に)…‘に'苦痛を与える(受動態にできない)
(比較変化なし)腹の,腹部の
《補語にのみ用いて》腹を立てて / 《補語にのみ用いて》(心が)鐘ついて / 不愉快な,気まずい
とうちゃん(papa)

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2016/04/21 13:32:18」(JST)

wiki en

Abdominal pain, also known as stomach pain or stomach ache, is a common symptom associated with both temporary, non-serious disorders and more serious conditions.

Common causes of pain in the abdomen include gastroenteritis and irritable bowel syndrome. In a third of cases the exact cause is unclear. About 10% of people have a more serious underlying condition such as appendicitis, leaking or ruptured abdominal aortic aneurysm, diverticulitis, or ectopic pregnancy.^[1] Determining the cause can be difficult, because many diseases can cause this symptom.

Differential diagnosis

The most frequent causes of abdominal pain are gastroenteritis (13%), irritable bowel syndrome (8%), urinary tract problems (5%), inflammation of the stomach (5%) and constipation (5%). In about 30% of cases, the cause is not determined. About 10% of cases have a more serious cause including gallbladder (stones or biliary dyskinesia) or pancreas problems (4%), diverticulitis (3%), appendicitis (2%) and cancer (1%).^[1] More common in those who are older, mesenteric ischemia and abdominal aortic aneurysms are other serious causes.^[2]

A more extensive list includes the following:

Gastrointestinal
- GI tract
  - Inflammatory: gastroenteritis, appendicitis, gastritis, esophagitis, diverticulitis, Crohn's disease, ulcerative colitis, microscopic colitis
  - Obstruction: hernia, intussusception, volvulus, post-surgical adhesions, tumours, severe constipation, hemorrhoids
  - Vascular: embolism, thrombosis, hemorrhage, sickle cell disease, abdominal angina, blood vessel compression (such as celiac artery compression syndrome), superior mesenteric artery syndrome, Postural orthostatic tachycardia syndrome
  - digestive: peptic ulcer, lactose intolerance, coeliac disease, food allergies
- Glands
  - Bile system
    - Inflammatory: cholecystitis, cholangitis
    - Obstruction: cholelithiasis, tumours
  - Liver
    - Inflammatory: hepatitis, liver abscess
  - Pancreatic
    - Inflammatory: pancreatitis
Renal and urological
- Inflammation: pyelonephritis, bladder infection
- Obstruction: kidney stones, urolithiasis, Urinary retention, tumours
- Vascular: left renal vein entrapment
Gynaecological or obstetric
- Inflammatory: pelvic inflammatory disease
- Mechanical: ovarian torsion
- Endocrinological: menstruation, Mittelschmerz
- Tumors: endometriosis, fibroids, ovarian cyst, ovarian cancer
- Pregnancy: ruptured ectopic pregnancy, threatened abortion
Abdominal wall
- muscle strain or trauma
- muscular infection
- neurogenic pain: herpes zoster, radiculitis in Lyme disease, abdominal cutaneous nerve entrapment syndrome (ACNES), tabes dorsalis
Referred pain
- from the thorax: pneumonia, pulmonary embolism, ischemic heart disease, pericarditis
- from the spine: radiculitis
- from the genitals: testicular torsion
Metabolic disturbance
- uremia, diabetic ketoacidosis, porphyria, C1-esterase inhibitor deficiency, adrenal insufficiency, lead poisoning, black widow spider bite, narcotic withdrawal
Blood vessels
- aortic dissection, abdominal aortic aneurysm
Immune system
- sarcoidosis
- vasculitis
- familial Mediterranean fever
Idiopathic
- irritable bowel syndrome (affecting up to 20% of the population, IBS is the most common cause of recurrent, intermittent abdominal pain)

Acute abdominal pain

Acute abdomen can be defined as severe, persistent abdominal pain of sudden onset that is likely to require surgical intervention to treat its cause. The pain may frequently be associated with nausea and vomiting, abdominal distention, fever and signs of shock. One of the most common conditions associated with acute abdominal pain is acute appendicitis.

Selected causes of acute abdomen

Traumatic: blunt or perforating trauma to the stomach, bowel, spleen, liver, or kidney
Inflammatory:
- Infections such as appendicitis, cholecystitis, pancreatitis, pyelonephritis, pelvic inflammatory disease, hepatitis, mesenteric adenitis, or a subdiaphragmatic abscess
- Perforation of a peptic ulcer, a diverticulum, or the caecum
- Complications of inflammatory bowel disease such as Crohn's disease or ulcerative colitis
Mechanical:
- Small bowel obstruction secondary to adhesions caused by previous surgeries, intussusception, hernias, benign or malignant neoplasms
- Large bowel obstruction caused by colorectal cancer, inflammatory bowel disease, volvulus, fecal impaction or hernia
Vascular: occlusive intestinal ischemia, usually caused by thromboembolism of the superior mesenteric artery

By location

Location^[3]

Upper middle abdominal pain
- Stomach (gastritis, stomach ulcer, stomach cancer)
- Pancreas pain (pancreatitis or pancreatic cancer, can radiate to the left side of the waist, back, and even shoulder)
- Duodenal ulcer, diverticulitis
- Appendicitis (starts here, after some time moves to lower right abdomen)
Upper right abdominal pain
- Liver (caused by hepatomegaly due to fatty liver, hepatitis, or caused by liver cancer, abscess)
- Gallbladder and biliary tract (gallstones, inflammation, roundworms)
- Colon pain (below the area of liver — bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer)
Upper left abdominal pain
- Spleen pain (splenomegaly)
- Pancreas
- Colon pain (below the area of spleen — bowel obstruction, functional disorders, gas accumulation, spasm, inflammation, colon cancer)
Middle abdominal pain (pain in the area around belly button)
- Appendicitis (starts here)
- Small intestine pain (inflammation, intestinal spasm, functional disorders)
Lower abdominal pain (diarrhea, colitis and dysentery)
Lower right abdominal pain
- Cecum (intussusception, bowel obstruction)
- Appendix point (Appendicitis location)
Lower left abdominal pain
- diverticulitis, sigmoid volvulus, obstruction or gas accumulation
Pelvic pain
- bladder (cystitis, may be secondary to diverticulum and bladder stone, bladder cancer)
- pain in women (uterus, ovaries, fallopian tubes)
Right lumbago and back pain
- liver pain (hepatomegaly)
- right kidney pain (its location below the area of liver pain)
Left lumbago and back pain
- less in spleen pain
- left kidney pain
Low back pain
- kidney pain (kidney stone, kidney cancer, hydronephrosis)
- Ureteral stone pain

Diagnostic approach

When a health care practitioner assesses a patient to determine the etiology and subsequent treatment for abdominal pain the history of the presenting complaint and physical examination should derive a diagnosis in over 90% of cases.

Investigations that aid diagnosis include

Blood tests including full blood count, electrolytes, urea, creatinine, liver function tests, pregnancy test, amylase and lipase.
Urinalysis
Imaging including erect chest X-ray and plain films of the abdomen
An electrocardiograph to rule out a heart attack which can occasionally present as abdominal pain

If diagnosis remains unclear after history, examination and basic investigations as above then more advanced investigations may reveal a diagnosis. These as such would include

Computed tomography of the abdomen/pelvis
Abdominal or pelvic ultrasound
Endoscopy and colonoscopy (not used for diagnosing acute pain)

Management

Butylscopolamine (Buscopan) is used to treat cramping abdominal pain with some success.^[4]

Epidemiology

Abdominal pain is the reason about 3% of adults see their family physician.^[1] Rates of emergency department visits in the United States for abdominal pain increased 18% from 2006 through 2011. This was the largest increase out of 20 common conditions seen in the ED. The rate of ED use for nausea and vomiting also increased 18%.^[5]

References

^ ^a ^b ^c Viniol, A; Keunecke, C; Biroga, T; Stadje, R; Dornieden, K; Bösner, S; Donner-Banzhoff, N; Haasenritter, J; Becker, A (October 2014). "Studies of the symptom abdominal pain--a systematic review and meta-analysis.". Family practice 31 (5): 517–29. doi:10.1093/fampra/cmu036. PMID 24987023.
^ Spangler, R; Van Pham, T; Khoujah, D; Martinez, JP (2014). "Abdominal emergencies in the geriatric patient". International journal of emergency medicine 7: 43. doi:10.1186/preaccept-3303381914150346. PMID 25635203.
^ Richard F.LeBlond. Diagnostics. US: McGraw-Hill Companies, Inc. ISBN 0-07-140923-8.
^ Tytgat GN (2007). "Hyoscine butylbromide: a review of its use in the treatment of abdominal cramping and pain". Drugs 67 (9): 1343–57. doi:10.2165/00003495-200767090-00007. PMID 17547475.
^ Skiner HG, Blanchard J, Elixhauser A (September 2014). "Trends in Emergency Department Visits, 2006-2011". HCUP Statistical Brief #179. Rockville, MD: Agency for Healthcare Research and Quality.

‹ The template below (Digestive system and abdomen symptoms and signs) is being considered for merging. See templates for discussion to help reach a consensus.›

UpToDate Contents

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1. 腹痛を有する成人の評価 evaluation of the adult with abdominal pain
2. 小児および思春期の慢性腹痛：評価のためのアプローチ chronic abdominal pain in children and adolescents approach to the evaluation
3. 小児および思春期における急性腹症の原因 causes of acute abdominal pain in children and adolescents
4. 成人における腹痛の原因 causes of abdominal pain in adults
5. 急性腹症を有する小児の緊急評価 emergent evaluation of the child with acute abdominal pain

English Journal

Acute aortic dissection (AAD) in the elderly.

Yeh YH, Su YJ, Liu CH.SourceDepartment of Emergency Medicine, Zhongxing Branch, Taipei City Hospital, Taipei, Taiwan; Department of Emergency Medicine, Mackay Memorial Hospital, Taipei, Taiwan.
Archives of gerontology and geriatrics.Arch Gerontol Geriatr.2013 Jul-Aug;57(1):78-80. doi: 10.1016/j.archger.2012.11.012. Epub 2012 Dec 28.
AAD is a relatively uncommon yet catastrophic disease. Though the relationship between AAD and age has been discussed in several previous studies, many facets of the relationship between AAD and the elderly still remain unclear. From a retrospective review of charts from January 1, 2005 to December
PMID 23276373

A randomized controlled trial of brief psychoanalytic psychotherapy in patients with functional dyspepsia.

Faramarzi M, Azadfallah P, Book HE, Tabatabaei KR, Taheri H, Shokri-Shirvani J.SourceSocial Determinants of Health Research Center, Department of Psychiatry, Faculty of Medicine, Babol University of Medical Sciences, Babol, Iran. Electronic address: Mahbob330@yahoo.com.
Asian journal of psychiatry.Asian J Psychiatr.2013 Jun;6(3):228-34. doi: 10.1016/j.ajp.2012.12.012. Epub 2013 Feb 15.
Functional dyspepsia (FD) is a common cause of upper gastrointestinal symptoms and discomfort. The present study aimed to assess the effectiveness of brief core conflictual relationship theme (CCRT) psychoanalytic psychotherapy on changing gastrointestinal symptoms, alexithymia, and defense mechanis
PMID 23642981

Efficacy of Bacillus clausii strain UBBC-07 in the treatment of patients suffering from acute diarrhoea.

Sudha MR, Bhonagiri S, Kumar MA.SourceCentre for Research & Development, Unique Biotech Limited, SP Biotech Park, Phase-II, Plot-2, Shameerpet, Hyderabad 500078, AP, India. sudha.ratna@gmail.com
Beneficial microbes.Benef Microbes.2013 Jun 1;4(2):211-6. doi: 10.3920/BM2012.0034.
This study was conducted to evaluate the anti-diarrhoeal activity of Bacillus clausii strain UBBC 07 in patients suffering from acute diarrhoea. A total of 27 patients (average age of 35.44±8.08 years) with acute diarrhoea were included in a prospective, Phase II clinical study after informed conse
PMID 23443952

Japanese Journal

症例胃アニサキス症を疑った誤飲爪楊枝による上腹部痛の1例

外科 = Surgey : 臨床雑誌 78(1), 86-88, 2016-01
NAID 40020696991

臨床研究・症例報告クローン病類似の内視鏡所見を呈した腹痛先行型IgA血管炎の1例

小児科臨床 69(1), 93-97, 2016-01
NAID 40020682407

急激に進展し腸管壊死を来した大腸癌の腫瘍栓による上腸間膜静脈閉塞症の1 例

日本血管外科学会雑誌 advpub(0), 2016
NAID 130005124617

Related Pictures

★リンクテーブル★

リンク元	「腹痛」「cramp」「腹部痛」
拡張検索	「lower abdominal pain」
関連記事	「pain」「abdominal」「pai」

「腹痛」

Abdominal pain
	Abdominal pain can be characterized by the region it affects.
Classification and external resources
Specialty	General surgery
ICD-10	R10
ICD-9-CM	789.0
DiseasesDB	14367
MedlinePlus	003120
Patient UK	Abdominal pain
MeSH	D015746
	[edit on Wikidata]

　　[★]

英: abdominal pain
関: PQRST、急性腹症

コアカリ診療の基本 p.107

心窩部	食道潰瘍	胸焼け、嚥下困難
	急性胃炎	悪心、嘔吐を伴う
	消化性潰瘍	空腹時悪化傾向
	胃癌	進行しないと痛まず
	虫垂炎初期	回盲部に圧痛
	急性膵炎	激烈な腹痛、背部痛、膵酵素の上昇
	慢性膵炎	不定の上腹部症状で神経症的にみえる
	膵臓癌	浸潤すると疼痛強し
右季肋部	胆石症	右肩に放散、発作間は痛みほとんどなし
	急性胆嚢炎	発熱、圧痛著明、肝胆道系酵素上昇
	急性肝炎	肝腫大、鈍痛、黄疸-肝酵素著明に上昇
	肝膿瘍	激しい発熱、叩打痛は肋骨弓部付近など
	肝癌	鈍痛、破裂すると激しい痛み
左右側腹部	尿管結石	肋骨脊椎角の叩打痛、血尿、超音波検査で水腎症
	腎盂腎炎	急激な発熱と叩打痛、膿尿
	腎梗塞	時に一過性の激しい痛み、血尿
回盲部	虫垂炎	他疾患除外の目的で、超音波検査が有用
	右側結腸憩室炎	虫垂炎との鑑別困難
	回腸末端炎	虫垂炎との鑑別が必要
	クローン病	回盲部潰瘍をきたしやすい
	大腸癌	右側結腸癌は腫癌を触知することが多い
左腸骨窩部	虚血性大腸炎	急激な腹痛と下血
	S状結腸憩室炎	腹痛、圧痛、発熱
	急性大腸炎	下痢、嬬動の元進
	S状結腸軸捻転	便秘老人、鼓腸強い、内視鏡的修復
下腹部	子宮付属器炎	発熱、圧痛
	卵巣嚢腫茎捻転	ショックに陥ることもあり、超音波検査が有用
	子宮外妊娠破裂	急激に貧血が進行、ショックなど
	生理痛	内膜症がある場合は強い
全体	腹膜炎	原発性、結核性、癌性など症状が微妙に異なる
	潰瘍穿孔	腹壁防御、板状硬、緊急手術
	腸間膜血栓症	鼓腸、腸麻痺、ショック、最も重篤